ArticlePLOS global public health2025
Cross-sectional study evaluating organizational climate, change commitment, and change efficacy for predicting family planning clinics' success in increasing HIV counseling and testing in Mombasa, Kenya.
Article in PLOS global public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Study protocol for the: HIV enhanced access testing in emergency department program using a systems analysis and improvement approach (HEATED-SAIA) cluster randomized trial.Implementation science communications · 2026Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Increasing HIV testing and counselling (HTC) is a first step to reducing HIV transmission. Implementing HTC in family planning (FP) clinics has been proposed to increase HIV testing coverage in at-risk populations. The Systems Analysis and Improvement Approach (SAIA) was used to improve HTC rates in FP clinics in Mombasa, Kenya. This hypothesis-generating exploratory analysis evaluated the associations between organizational climate characteristics, organizational readiness for implementing change, and successful implementation of HTC. Surveys were conducted with clinic managers and staff from FP clinics implementing SAIA to increase HTC. Likert-style questions were used to characterize organizational climate metrics and organizational readiness for implementing change (ORIC). Linear regression was performed to examine the association between organizational climate metrics, ORIC domains, and two FP client outcomes: 1) percentage of clients receiving pre-HIV test counseling, and 2) percentage of clients tested for HIV. Eleven clinic staff and 10 clinic managers completed the surveys. For clinic staff, higher innovation and flexibility scores were associated with higher change commitment (β = 0.20, CI 0.09-0.31, p = 0.001) and change efficacy (β = 0.17, CI 0.07-0.26, p = 0.002). Higher clinic manager scores for innovation and flexibility were associated with a higher change commitment (β = 0.44, CI 0.04-0.84, p = 0.03). Additionally, clinic managers' scores for management support (β = 0.25, CI 0.06-0.45, p = 0.01), commitment to facility (β = 0.78, CI 0.60-0.96, p = 0.001), and relative priority (β = 0.24, CI 0.08-0.39, p = 0.004) were positively associated with higher change commitment and change efficacy. In contrast, clinic managers' scores for tradition were negatively associated with change commitment (β = -0.38, CI -0.75-0.01, p = 0.05). Clinic staff perceptions of management support were positively associated with the proportion of clients counseled for HIV testing (β = 1.20, CI 0.08-2.32, p = 0.04). Support from leadership and innovation/flexibility are important predictors of change commitment and change efficacy. Strong management support may increase the likelihood of successful implementation of SAIA to improve HTC.
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Registered trials
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